Status: Finalised
First registered on:
27/01/2017
Last updated on:
02/05/2019
1. Study identification
EU PAS Register NumberEUPAS15063
Official titleDrug utilization study of mirabegron (Betmiga®) using real-world healthcare databases from the Netherlands, Spain, United Kingdom and Finland
Study title acronymMirabegron DUS
Study typeObservational study
Brief description of the studyThe mirabegron (Betmiga®) Summary of Product Characteristics (SmPC) states that the drug is contraindicated in patients with “Severe uncontrolled hypertension defined as systolic blood pressure ≥180 mm Hg and/or diastolic blood pressure ≥110 mm Hg”. In accordance and compliance with the European Medicines Agencies (EMA’s) Pharmacovigilance Risk Assessment Committee (PRAC) request, a Direct Healthcare Professional Communication (DHPC) letter was disseminated on 7 September 2015 as a risk minimization activity in 30 countries in EU. In line with the EMA CHMP guideline Module IX, an effectiveness check of this risk minimization activity was proposed by Astellas. A drug utilization study (DUS) on the use of mirabegron in the Netherlands, Spain, United Kingdom and Finland will be performed as a risk minimization effectiveness check measure.
The objectives of the study are to assess the effectiveness of the Direct Healthcare Professional Communication (DHPC) letter as a risk minimization measure in the participating countries by quantifying the proportions of mirabegron initiators with documented severe uncontrolled hypertension (primary objective) and the frequency of blood pressure recordings at baseline and during mirabegron treatment, especially in hypertensive patients (secondary objective) before and after DHPC dissemination.
Was this study requested by a regulator?Yes: EMA
Is the study required by a Risk Management Plan (RMP)?
EU RMP category 3 (required)
Regulatory procedure number (RMP Category 1 and 2 studies only)
Other study registration identification numbers and URLs as applicable
2. Research centres and Investigator details
Coordinating study entity
Department/Research group
Organisation/affiliationThe PHARMO Institute for Drug Outcomes Research
Details of (Primary) lead investigator
Title Dr
Last name Herings
First name Ron
Is this study being carried out with the collaboration of a research network?
No
Other centres where this study is being conducted
Multiple centres
In total how many centres are involved in this Study?4
Countries in which this study is being conducted
International study
Finland
Netherlands
Spain
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed26/07/2016
Start date of data collection21/02/2017
Start date of data analysis17/03/2017
Date of interim report, if expected
Date of final study report11/07/2018
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesAstellas100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Bezemer
First name Irene
Address line 1Van Deventerlaan 30-40
Address line 2
Address line 3
CityUtrecht
Postcode
CountryNetherlands
Phone number (incl. country code)0031307440800
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name Herings
First name Ron
Address line 1Van Deventerlaan 30-40
Address line 2
Address line 3
CityUtrecht
Postcode3528 AE
CountryNetherlands
Phone number (incl. country code)31307440800
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)G04BD12 (mirabegron)
7. Medical conditions to be studied
Medical condition(s)Yes
Hypertension
8. Population under study
Age
Adults (18 - 44 years)
Adults (45 - 64 years)
Adults (65 - 74 years)
Adults (75 years and over)
Sex
Male
Female
9. Number of subjects
Estimated total number of subjects50000
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources registered with ENCePP
Data sources not registered with ENCePP
Finnish data accessed and analysed by EPID Research, Finland
Sources of data
Administrative database, e.g. claims database
Routine primary care electronic patient registry
Pharmacy dispensing records
The Finnish data sources include the e-Prescription Register, Care Register for Health Care, Register of Primary Health Care Visits, Population Register Centre and Causes of Death Registry of Finland and electronic medical record databases of city of Helsinki, Vantaa and Espoo.
11. Scope of the study
What is the scope of the study?
Risk minimization
Primary scope : Risk minimization
12. Main objective(s)
What is the main objective of the study?
The objectives are to assess the effectiveness of the DHPC letter as a risk minimization measure by quantifying the proportions of mirabegron initiators with severe uncontrolled hypertension (primary objective) and the frequency of blood pressure recordings at baseline and during mirabegron treatment, especially in hypertensive patients (secondary objective) before and after DHPC dissemination.
Are there primary outcomes?Yes
For the primary objective we will assess whether the proportions of mirabegron initiators with documented hypertension (severe uncontrolled hypertension but also controlled hypertension or non-severe uncontrolled hypertension) differ between the time periods before and after DHPC dissemination.
Are there secondary outcomes?Yes
For the secondary objective we will asses whether the frequency of blood pressure recordings at initiation and during mirabegron treatment among initiators with documented hypertension at index date differ between the time periods before and after DHPC dissemination.
13. Study design
What is the design of the study?
Cohort study
14. Follow-up of patients
Will patients be followed up?Yes
Please describe duration of follow up
The number of blood pressure recordings (i.e. whether it was monitored regardless of the outcome) will be assessed during mirabegron treatment.
15. Data analysis plan
Please provide a brief summary of the analysis method
The DHCP letter was disseminated on 7 September 2015. The analysis pre- and post dissemination will take this date as the intervention date. Besides a pre- and post dissemination analysis, incremental changes over time will be assessed using the aggregated data per quarter (January-March, April-June, July-September and October-December).
To estimate incremental changes in response to the DHPC letter in the proportion of mirabegron initiators with normal blood pressure, controlled hypertension, non-severe uncontrolled hypertension and severe uncontrolled hypertension at index date (primary objective), an interrupted time series approach will be applied on the respective proportions in each quarter.
The frequency of blood pressure recordings will be assessed before initiation of and during mirabegron treatment (see section 9.3.4). Blood pressure recordings at or before index date (up to 6 months) will be reported separately from the recordings during treatment.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
No
17. Full protocol
18. Study Results
Please list the 5 most relevant publications using data from your study
ReferenceLink to web-publication
None
19. Other relevant documents
Conflict(s) of interest of
investigator(s)Not submitted
Composition of Steering Group and
ObserversNot submitted
Other documentsNot
submitted
Signed Code of
Conduct Checklist
Not submitted
Signed Code of Conduct Declaration
Not submitted
Signed Checklist for Study
Protocols
Not submitted
